Healthcare Provider Details

I. General information

NPI: 1710843677
Provider Name (Legal Business Name): TAYLOR LECIANNE SMITH APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 GRAFTON AVE
DAYTON OH
45406-5202
US

IV. Provider business mailing address

919 HILE LN
ENGLEWOOD OH
45322
US

V. Phone/Fax

Practice location:
  • Phone: 629-277-2837
  • Fax: 937-276-4555
Mailing address:
  • Phone: 937-417-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0041234
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: